Online ISSN: 2515-8260

Keywords : pre-eclampsia


A COMPARATIVE STUDY OF SERUM CALCIUM, MAGNESIUM AND URIC ACID LEVELS IN WOMEN WITH PRE-ECLAMPSIA AND NORMAL PREGNANCY

Swapnarani Seedipally, Malathi Verabelly, Anees Sultana

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 2840-2847

Background: Physiologically calcium plays a critical role in function of smooth muscle and its deficiency can cause increased blood pressure. Magnesium is a cofactor in several enzymes, cause vasodilatation and helps in neurochemical transmission. Besides magnesium and calcium, hyperuricemia may induce hypertension by impairing nitric oxide generation
Objective: To compare serum calcium, magnesium and uric acid levels in women with pre-eclampsia and normal pregnancy
Methods: Hospital based Comparative Cross sectional study was carried out among 60 (30 pre-eclampsia and 30 normal pregnant women) aged 18-35 years between 20 weeks till term gestation for 18 months. Proteinuria, serum Calcium, Serum Magnesium, and serum Uric acid were measured using standard procedures.
Results: Majority were (40%) 25-29 years, (53.3%) were overweight, 46.6% had 36-38 weeks of gestation. 56.67% were Primi. 60% had severe preeclampsia. Proteinuria was seen in all with 46.67% had 2+. Pulse rate, SBP and DBP were significantly higher among the cases compared to controls.  Serum calcium was significantly lower among preeclampsia women and serum uric acid was significantly higher.  However there was no statistically significant difference between serum magnesium levels among preeclampsia and normal pregnant women. There was no statistically significant difference between pulse rates. Systolic and diastolic blood pressure were significantly higher in severe preeclampsia group. Serum Calcium and magnesium were significantly lower in severe preeclampsia group.
Conclusion: Preeclampsia was found to be associated with low calcium levels and higher serum uric acid levels. But it was not found to be associated with the serum magnesium levels.

The role of uterine artery Doppler in the prediction of pre-eclampsia at 13- to 16-week gestation

Ishpreet Kaur Kukreja; Sanjay Kumar Patil; Supriya Patil; Yamini Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 5211-5219

Objective: Uterine artery Doppler flow assessment during early pregnancy can help in the prediction of pre-eclampsia. The present study aimed to assess the role of uterine artery Doppler ultrasound in early prediction of pre-eclampsia at 13-16 weeks of gestation.
Methodology: This observational study included 80 antenatal women, aged 16-35 years, with 13-16 weeks of gestational age with singleton pregnancy, from December 2017 - June 2019. Demographic data, medical history was collected. Doppler assessment of the uterine arteries was performed at 13-16, 24-26 weeks of gestation to record uterine artery diastolic notch (UADN) and uterine artery Doppler indices, viz, resistance index (RI) and pulsatility index (PI). Pregnancy events, delivery and neonatal outcome were noted during follow up. Statistical analysis was performed by using R software (Version 3.6.0).
Results: Prevalence rate of pre-eclampsia was 12.5%.  At 12-16 weeks, UADN was seen in 35% cases with mean RI, PI of 0.62 and 0.96. At 24-26 weeks, it was noted in 15% of the study cases (RI: 0.53 and PI: 0.79). A significant (P<0.05) association was observed between UADN at 24-26 weeks and development of pre-eclampsia. At 13-16 weeks gestation, the specificity and positive predictive value (PPV) for UADN were 70.49 and 35.7%, respectively; whereas when UADN and RI were considered together, the specificity and PPV increased to 100%.
Conclusion: The uterine artery Doppler ultrasound effectively predicted the development of pre-eclampsia during early pregnancy (13 to 16 weeks gestation) screening.

Clinical Study of Neonates Born to Mothers with Hypertensive Disorders of Pregnancy (HDP)

Gajula Ravi, Janardhan Reddy Pulluru, Suraboina Satishkumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10414-10423

Background:Globally, hypertensive disorders of pregnancy (HDP) are one of the major
causes of perinatal and maternal morbidity and mortality. These disorders are
characterized by increase in blood pressure (BP) which may be present before or
appear for the first time during pregnancy after 20 weeks with or without proteinuria
or evidence of multiorgan involvement and have been classified into preeclampsia (PE)
and eclampsia syndrome, chronic hypertension (CH), PE superimposed on CH, and
gestational hypertension. The HDP may complicate 5%–10% of all the pregnancies
with the prevalence of 6.9%–7.9% in India. Studies have shown that HDP accounts for
around 16% of 2.6 million stillbirths and 15% of perinatal deaths globally. Higher rates
of adverse perinatal outcome such as preterm delivery, low birth weight, birth asphyxia,
stillbirth, and early death have been reported worldwide in women having
HDP.Prematurity and preterm birth are documented as the most common cause of
perinatal death in Indian women with HDP. The present study was conducted with the
aim to know the type of hypertension affecting the pregnant women and perinatal
outcome.Aims and objectives:To determine the outcome of neonates born to mothers
with Hypertensive Disorders of pregnancy in comparison with neonatal outcome in
babies born to normotensive mothers.
Materials and Methods: A comparative case control study will be performed on
Neonates fitting into inclusion criteria from JAN 2019 to Jun 2020 and a
prestructuralperforma will be used to obtain detailed History taking, Clinical
examination .The comparison will be done between two groups. The study group, which
will include neonates born to mothers with either gestational hypertension,
preeclampsia or eclampsia. The control group, which will include all babies born to
normotensive mothers, matched forgestation with the study group during the study
period.
Results: The results showed that the primary and the secondary outcomes in the study
group was significantly poorer compared to control group. There was significantly high
rate of death among the neonates born in the study group (p< 0.05).Also there was
higher rate of meconium stained amniotic fluid (16%), more requirement of surfactant
(14%) and more requirement of NICU admission (31%) among the study group. There
was also higher rate of IUGR (20%) as well as higher rates of Low birth weights among
study group.

Association between second trimester maternal serum alphafetoprotein in 14-22 weeks and adverse pregnancy outcome

Heena Mir, Saima Sadiq,Sabha Malik

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 225-230

Background:Many screening tests are available for predicting adverse pregnancy outcome
and these range from non- invasive to invasive and serum alpha-fetoprotein level
estimation is one of them. The present study was conducted to assess association between
second trimester maternal serum alpha-fetoprotein in 14-22 weeks and adverse pregnancy
outcome.
Materials & Methods: 250 patients of gestational age between 14-22 weeks were included.
Maternal serum alpha-fetoprotein was measured in human serum by microplateimmunoenzymometric
assay by EIA-AFP kit. Maternal serum alpha-feto protein level was
expressed in IU/ml.
Results: 23 (9.2%) participants out of 250 developed preterm labor. 21 out of 23 had raised
value of maternal serum alpha-fetoprotein. 20 (8%) patients out of 250 patients developed
oligohydramnios. 13 out of 20 had raised value of maternal serum alpha-fetoprotein. 14
(5.6%) patients out of 250 developed pre-eclampsia, 11 out of 14 had raised values of
maternal serum alpha-fetoprotein. 7 (2.8%) patients out of 250 developed premature
rupture of membrane (PROM). 4 out of 7 had raised values of maternal serum alphafetoprotein.
Conclusion: There is an increased risk of pre-eclampsia, preterm delivery,
oligohydramnios and premature rupture of membrane with elevated maternal serum
alpha-fetoprotein levels